Fluoroscopy-guided percutaneous lithotripsy using FREDDY laser for giant gallstones: Preliminary experience.

Abstract

OBJECTIVES:

Percutaneous treatment of symptomatic cholelithiasis with large gallstones remains a challenge. We aimed to evaluate the efficacy and safety of a new method for the removal of giant gallstones with percutaneous lithotripsy using a frequency-doubled double-pulse neodymium: YAG (FREDDY) laser.

MATERIALS AND METHODS:

This study included 16 patients (7 males, 9 females; mean age, 63.4 ± 14.9 years) with giant gallstones who experienced the recurrence of cholecystitis and were not eligible for operation. The percutaneous transcystic approach was established using an 8-French sheath. A 6-French steerable sheath were inserted through the sheath. FREDDY laser lithotripsy was performed to break the stones into fragments. The stone fragments were extracted through the 6-French sheath or pushed into the duodenum using a balloon catheter. Cholecystography was performed before removing the catheter. Follow-up ultrasound or computed tomography examination were performed.

RESULTS:

Gallstone clearance was accomplished in 16 (100%) patients at the initial assessment. Eleven patients underwent one session, and five patients underwent two sessions. Residual stones were found in 3 (18.8%) patients during the follow-up period. Peritonitis was found in two (12.5%) patients and hemocholecyst was detected in one (6.3%) patient. No procedure-related deaths occurred.

CONCLUSION:

Percutaneous lithotripsy using a FREDDY laser may be an effective and safe alternative choice for treating giant gallstones, especially for patients who are not eligible for cholecystectomy.

• Authors: Wujie Wang, Wei Wang, Bin Liu, Yuliang Li
• Journal: Lasers in surgery and medicine (Lasers Surg Med) Vol. 54 Issue 3 Pg. 392-398 (03 2022) ISSN: 1096-9101 [Electronic] United States
• PMID: 34463963 (Publication Type: Case Reports, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 Wiley Periodicals LLC.

Topics

• Aged
• Female
• Fluoroscopy
• Gallstones (surgery, therapy)
• Humans
• Lasers, Solid-State (therapeutic use)
• Lithotripsy, Laser (methods)
• Male
• Middle Aged